结构脂肪乳对肝癌术后肝功能、免疫功能及肝再生相关因子的影响

Effect of Structured Triglycerides on Liver Function,Immune Function and Liver Regeneration Related Factors in Post-Operation Patients with Liver Cancer

目的探讨结构脂肪乳对肝癌患者肝脏部分切除术后的肝功能、免疫功能及肝再生相关因子的影响。方法选取北京医院2015年12月~2017年12月进行部分肝切除手术的肝癌患者60例,数字表法随机分为两组,术后第1天起分别予以不同脂肪乳配方的肠外营养支持5天,观察组30例选用20%结构脂肪乳(STG组),对照组30例选用20%中长链脂肪乳(MCT/LCT组)。对比观察术前、术后第3天、第7天外周血IL-6、HGF、C-met、T淋巴细胞亚群CD3+、CD4+百分比、CD4+/CD8+以及TBIL、AST、ALT、GGT、GLU指标变化。结果术前两组一般情况及各指标比较,差异无统计学意义;STG组AST、ALT水平在术后第7天明显低于MCT/LCT组(P<0.05),TBIL水平在术后第3天明显低于MCT/LCT组(P<0.05);CD3+%、CD4+%水平在术后第3天、第7天明显高于MCT/LCT组(P<0.05),CD4+/CD8+水平在术后第7天明显高于MCT/LCT组(P<0.05),HGF水平在术后第3天、第7天明显高于MCT/LCT组(P<0.05)。结论富含STG的肠外营养支持可以较好地改善肝癌患者术后肝功能及免疫功能,提高HGF水平,对肝再生可能起到促进作用。

Objective To investigate the effect of structured triglycerides on liver function,immune function and factors related to liver regeneration in in post-operation patients with liver cancer.Methods A total of 60 cases of hepatocellular carcinoma patients after partial hepatectomy were included in this study.And they were randomly divided into two groups based on formulations of fat emulsion delivered for postoperative parenteral nutrition support,in which the control group was applied with 20%medium/long chain fat emulsion(group MCT/LCT),and the study group was treated with 20%structured triglycerides(group STG).Patients underwent parenteral nutrition for 5 days.Peripheral blood were collected from all patients pre-operation,3rd and 7th days post-operation to monitor IL-6,HGF,C-met and T cell subsets CD3+%,CD4+%,CD4+/CD8+,and TBIL,AST,ALT,GGT,GLU levels,then we compared them between the two groups.Results There were no significant differences between the two groups when comparing the general conditions and each index before the operation.Compared with group MCT/LCT,AST,ALT levels were lower on 7th day postoperation in group STG,and TBIL levels were significantly lower on 3rd day postoperation(P<0.05);CD3+%、CD4+%、levels were significantly higher on 3rd and 7th day postoperation in group STG(P<0.05),and CD4+/CD8+levels were significantly higher on 7th day postoperation in group STG(P<0.05).HGF levels were significantly higher on 3rd and 7th day postoperation in group STG(P<0.05).Conclusion In the hepatocellular carcinoma patients after partial hepatectomy,STG based parenteral nutrition can promote the recovery of liver function and immune function,improve the level of HGF,and may be benefit for liver regeneration.